Tomoelastography Based on Multifrequency MR Elastography for Prostate Cancer Detection: Comparison with...

Area of Science:

• Medical Imaging
• Radiology
• Oncology

Background:

• Multiparametric MRI (mpMRI) is standard for prostate cancer (PCa) detection.
• Current mpMRI lacks assessment of mechanical tissue alterations caused by PCa.
• Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 is a widely used scoring system for PCa diagnosis.

Purpose of the Study:

• To evaluate the diagnostic performance of tomoelastography-quantified stiffness and fluidity for PCa detection.
• To compare the diagnostic accuracy of tomoelastography-enhanced mpMRI with standard PI-RADS v2.1.

Main Methods:

• Prospective study involving participants suspected of PCa and healthy controls.
• Participants underwent multiparametric MRI and tomoelastography.
• Tomoelastography quantified shear-wave speed (stiffness) and loss angle (fluidity); diagnostic performance assessed using AUC analysis.

Main Results:

• Tomoelastography parameters (stiffness and fluidity) were significantly higher in PCa compared to benign prostatic disease and healthy controls (P < .001).
• Incorporating stiffness and fluidity (AUC, 0.95) significantly improved diagnostic performance over PI-RADS v2.1 alone (AUC, 0.85; P < .001).
• The combined approach achieved 95% specificity for PCa detection, outperforming mpMRI alone (77%).

Conclusions:

• Tomoelastography-quantified stiffness and fluidity enhance the diagnostic performance of mpMRI for PCa.
• This technique improves the differentiation of PCa from benign conditions in both peripheral and transition zones.
• Tomoelastography offers a valuable addition to current imaging protocols for accurate prostate cancer diagnosis.